The sulcus line of the trochlear groove is more accurate than Whiteside's Line in determining femoral component rotation

Verfasser / Beitragende:
[Simon Talbot, Pandelis Dimitriou, Ross Radic, Rachel Zordan, John Bartlett]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/11(2015-11-01), 3306-3316
Format:
Artikel (online)
ID: 605460876
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024 7 0 |a 10.1007/s00167-014-3137-8  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00167-014-3137-8 
245 0 4 |a The sulcus line of the trochlear groove is more accurate than Whiteside's Line in determining femoral component rotation  |h [Elektronische Daten]  |c [Simon Talbot, Pandelis Dimitriou, Ross Radic, Rachel Zordan, John Bartlett] 
520 3 |a Purpose: The sulcus line (SL) is a three-dimensional curve produced from multiple points along the trochlear groove. Whiteside's Line, also known as the anteroposterior axis (APA), is derived from single anterior and posterior points. The purposes of the two studies presented in this paper are to (1) assess the results from the clinical use of the SL in a large clinical series, (2) measure the SL and the APA on three-dimensional CT reconstructions, (3) demonstrate the effect of parallax error on the use of the APA and (4) determine the accuracy of an axis derived by combining the SL and the posterior condylar axis (PCA). Methods: In the first study, we assessed the SL using a large, single surgeon series of consecutive patients undergoing primary total knee arthroplasties. The post-operative CT scans of patients (n=200) were examined to determine the final rotational alignment of the femoral component. In the second study, measurements were taken in a series of 3DCT reconstructions of osteoarthritic knees (n=44). Results: The mean position of the femoral component in the clinical series was 0.6° externally rotated to the surgical epicondylar axis, with a standard deviation of 2.9° (ranges from −7.2° to 6.7°). On the 3DCT reconstructions, the APA (88.2°±4.2°) had significantly higher variance than the SL (90.3°±2.7°) (F=5.82 and p=0.017). An axis derived by averaging the SL and the PCA+3° produced a significant decrease in both the number of outliers (p=0.03 vs. PCA and p=0.007 vs. SL) and the variance (F=6.15 and p=0.015 vs. SL). The coronal alignment of the SL varied widely relative to the mechanical axis (0.4°±3.8°) and the distal condylar surface (2.6°±4.3°). Conclusions: The multiple points used to determine the SL confer anatomical and geometrical advantages, and therefore, it should be considered a separate rotational landmark to the APA. These findings may explain the high degree of variability in the measurement of the APA which is documented in the literature. Combining a geometrically correct SL and the PCA is likely to further improve accuracy. 
540 |a Springer-Verlag Berlin Heidelberg, 2014 
690 7 |a Knee  |2 nationallicence 
690 7 |a Arthroplasty  |2 nationallicence 
690 7 |a Rotation  |2 nationallicence 
690 7 |a Femoral component rotation  |2 nationallicence 
690 7 |a Total knee arthroplasty  |2 nationallicence 
690 7 |a Whiteside's Line  |2 nationallicence 
690 7 |a Sulcus line  |2 nationallicence 
690 7 |a Epicondylar axis  |2 nationallicence 
700 1 |a Talbot  |D Simon  |u Western Health, Melbourne, VIC, Australia  |4 aut 
700 1 |a Dimitriou  |D Pandelis  |u Western Health, Melbourne, VIC, Australia  |4 aut 
700 1 |a Radic  |D Ross  |u Western Health, Melbourne, VIC, Australia  |4 aut 
700 1 |a Zordan  |D Rachel  |u Warringal Private Hospital, Melbourne, VIC, Australia  |4 aut 
700 1 |a Bartlett  |D John  |u Warringal Private Hospital, Melbourne, VIC, Australia  |4 aut 
773 0 |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/11(2015-11-01), 3306-3316  |x 0942-2056  |q 23:11<3306  |1 2015  |2 23  |o 167 
856 4 0 |u https://doi.org/10.1007/s00167-014-3137-8  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
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950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00167-014-3137-8  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Talbot  |D Simon  |u Western Health, Melbourne, VIC, Australia  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Dimitriou  |D Pandelis  |u Western Health, Melbourne, VIC, Australia  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Radic  |D Ross  |u Western Health, Melbourne, VIC, Australia  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Zordan  |D Rachel  |u Warringal Private Hospital, Melbourne, VIC, Australia  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Bartlett  |D John  |u Warringal Private Hospital, Melbourne, VIC, Australia  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/11(2015-11-01), 3306-3316  |x 0942-2056  |q 23:11<3306  |1 2015  |2 23  |o 167